Use of Personal Ritual among Hospice Staff Following the Death of a Patient


Lori P. Montross, PhD
San Diego Hospice and the Institute
for Palliative Medicine, San Diego, California, USA


After the death of those close to us we often feel the need to have a sacred ritual to honor their lives. To date, research has focused on family members’ use of rituals after the death of their loved ones, but little has been studied regarding hospice staff who can also be personally impacted by patients’ deaths. Hospice staff may experience greater levels of burnout and stress due to their daily or weekly experiences of loss. This study will examine the use of personally meaningful rituals as hospice staff and volunteers cope with the deaths of their patients. One innovation of this study will be that all hospice staff and volunteers will be invited to participate─from housekeepers, cafeteria workers, social workers, and chaplains to music therapists, nurses, office staff, and physicians. This inclusive design will offer a unique insight into the practices of all team members in their care of the dying.

Through an online survey, participants will be asked to describe their ritual practices, to elaborate on how they created them, and to express how these practices impact their work. Each participant will complete an online validated measure of their Professional Quality of Life (ProQoL), providing data about their level of compassion fatigue and compassion satisfaction. The 20 participants who rate highest in compassion satisfaction will then be given an in-depth qualitative interview.

The results should help new staff learn from more established staff, possibly leading to reduced frustration, isolation, or burnout as they cope with patients’ deaths. Administrators should gain new ideas for meaningful organizational practices, ones that enrich staff and their desire for positive patient remembrances. Finally, for the wider medical community, we believe this study could start a beneficial dialogue across medical professions, with the aim of showing how the use of personally meaningful rituals may bolster coping and compassion in one’s work.